Clinical Pragmatism Creatively Combines Pragmatic Ethics with Sense of Coherence and Evidence-based Practice

Abstract This article describes the development of biomedical ethics from a deductive, principlist approach to an inductive, pragmatic ethics framework. This approach is driven by the necessity of ethics-based decision-making in clinical environments. Pragmatic ethics puts more emphasis on the practice of practical, useful, and beneficial actions based on individual patient needs. Therefore, this shift from the traditional deontological principles demonstrates the trend toward ethics applied in real life, with the use of case scenarios on critical medical decisions as an example. Central to the pragmatic ethics approach are three pillars: a pragmatic method of inquiry that uses the best available evidence, contextual problem-solving, and collaboration with patients in decision-making. The text contrasts pragmatic ethics with utilitarian ethics by using examples to show how pragmatism focuses on realistic outcomes rather than abstract ideals. This, for its part, introduces Clinical Pragmatism as one of the required skills by the clinicians that covers an 11-step process that has integration in both evidence-based medicine (EBM) and a sense of coherence (SOC). EBM grounds the clinical practices on the best available evidence, whereas SOC brings about an all-encompassing comprehension of values and needs in patients. It, therefore, augments the outcome of treatment. In conclusion, pragmatic ethics, especially within clinical practice, offers a flexible and nuanced framework that respects patient autonomy and aligns with the evolving complexities of healthcare, balancing ethical principles with practical application to optimize patient care.